If You Can Measure It …

Every business can be reduced to a handful of numbers that can tell you at a high level how your business is performing. These key performance indicators become the guages on the dashboard of your business that can tell you when you need to pay special attention and potentially think aobut making changes. As the old saying goes, “if you can measure it, you can manage it.”  The first step in the process of business improvement is to identify the key performance indicators of your business and start measuring them regularly. Once you are measuring them, you can establish a baseline – a measure of where your business is today.

Develop Strategies to Reduce Claim Denials

You can lower your accounts receivable days, reduce rework of claims, and increase patient satisfaction by: 1) identifying key problem areas, 2) developing strategies to reduce claim denials, 3) engaging and empowering your staff to employ these strategies. By monitoring your most frequent claim denial reasons, you can identify problem areas. Use your practice management system or denial analysis reports provided by your billing service to track and monitor denial reasons. The key to using this information wisely is to share it with the staff responsible. For example, if there is a trend in denials for member eligibility, implement a policy and procedure for staff who register patients to verify insurance eligibility and benefits. Ensure that your staff have the training and tools to verify insurance eligibility and benefits. On an ongoing basis, provide regular feedback of denial trends to monitor the effectiveness of your strategies.

Providers and their staff who understand how they impact claim denials and cash flow can develop effective strategies to reduce claim denials. The result of employing effective strategies has been shown to lower days AR, reduce the amount of effort in getting claims paid, and increase employee and patient satisfaction.